MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera...
Transcript of MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera...
![Page 1: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/1.jpg)
REPUBLIC OF HAITI
MINISTRY OF PUBLIC HEALTH AND POPULATION
NATIONAL DIRECTORATE FOR WATER SUPPLY AND SANITATION
NATIONAL PLAN FOR THE ELIMINATION OF CHOLERA IN HAITI
2013-2022
SHORT TERM PLAN 2013-2015
![Page 2: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/2.jpg)
REPUBLIC OF HAITI
Elimination�of�Cholera�in�Haiti���
IMPLEMENTATION�IN�THE�SHORT�TERM��2013–2015�
PortͲauͲPrince,�Haiti�December�2012
2
![Page 3: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/3.jpg)
3
TABLE�OF�CONTENTS��������� � � � � � � � � � � ���������� � � �� � � � � � � � � � � � � � � ��� � � ����PAGE�
I�Ͳ�CONTEXT�� � � � � � � � � � � � � � � � �� ��4�
II�Ͳ�EPIDEMIOLOGY�OF�THE�CHOLERA�EPIDEMIC�IN�HAITI�� � � � � � � � � � ��6�
III�Ͳ�OBJECTIVES�OF�THE�ACTION�PLAN� � � � � � � � � � � � �����������11�
IV�Ͳ�SHORTͲTERM�INTERVENTIONS� � � � � � � � � � � � � �����������12�
V�Ͳ�EXPECTED�RESULTS� � � � � � � � � � � � � � � �����������15�
VI�Ͳ�INDICATORS� � � � � � � � � � � � � � � � �����������16�
VII�Ͳ�ACTIVITIES�AND�COST�OF�IMPLEMENTING�THE�PLAN�OF�ACTION�� � � � � � � �����������16�
VIII�Ͳ�MONITORING�AND�EVALUATION� � � � � � � � � � � � �����������17�
IX�–�ACTION�PLAN�(SUMMARY),�SHORTͲTERM,�2013–2015/FINANCING�REQUIRED� � � � � �����������19�
���������DINEPA:���������������������Ͳ�INSTITUTIONAL�STRENGTHENING� � � � � � � � � �����������20���������������� Ͳ�ACCESS�TO�POTABLE�WATER� � � � � � � � � � �����������24�
��������������������������������������� Ͳ�TREATMENT�OF�WASTEWATER�AND�EXCRETA��� �� � � � � � �����������27����������PUBLIC�HEALTH:�������Ͳ�MANAGEMENT� � � � � � � � � � � � �����������32�� ������������������������������� Ͳ�VACCINATION� � � � � � � � � � � � �����������36�� � � �������� Ͳ�MEDICINES�AND�INPUTS� � � � � � � � � �� �����������37�� � � �������� Ͳ�EPIDEMIOLOGICAL�SURVEILLANCE� � � � � � � � � �����������42�� � � � Ͳ�HEALTH�PROMOTION� � � � � � � � � � � �����������44�
![Page 4: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/4.jpg)
I�Ͳ�CONTEXT�
Ten� months� after� the� devastating� earthquake� of� 10� January� 2010,� Haiti� experienced� one� of� the� largest� cholera�
epidemics� in�modern�history.�The � first � cases � of � cholera �were � discovered � in � Haiti � in �October � 2010 � in � the �
Central �Department. �A �month � later, �cholera �spread� into �all �of �Haiti �and � to � the �Dominican �Republic. �As�
of�3�July�2012,�there�had�been�a�total�of�577,858�cases�of�cholera�in�Haiti,�among�which�312,449�had�been�hospitalized�
and�7,413�had�died.�This�represents �the � largest �epidemic �ever �recorded � in �a �single �country � in �the �world. �In�
the�Dominican�Republic,�the�first�case�of�cholera�was�reported�in�November�2010.��In �the �Dominican �Republic, �the �
first � cholera � case � was � reported � in � November � 2010. � By � 31 � December � 2012,� there � had � been � 29,433�
suspected �cases, �422 � fatalities �and �a � fatality �rate �of �0.7% � in �the �Dominican �Republic. �There � is �a �risk �of �
cholera �becoming �endemic �on �the � island �of �Hispaniola. � � �
�
The � different �manner � in �which � the � disease � spread� in � the � two � countries � is � explained � in � part � by � health �
conditions � that �persist �on � the � island. �At � the � start �of � the �epidemic, � it �was �estimated � that, � in �Haiti, �31% �
of � the � population � had � no � access � to � potable � water, � and � 83% � of � the � population � had � no � access � to �
4
![Page 5: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/5.jpg)
5
adequate � facilities � for � excreta � disposal. 1� The � lack� of � good � hygiene � practices � among � most � of � the �
population, � and � particularly � among � groups � without � access � to � basic � health � services,� was � among � the �
factors � that � furthered � the � rapid � spread � of � the � disease. � In� addition, � even � before � the � earthquake � in �
January � 2010 � and � the � cholera � outbreak � in � October � of � that � same � year, � 46% � of � the � Haitian � population �
had �no �access � to �health � care. �Access � is �defined � in �part �by � the �distance � that �must �be � traveled � to � reach �
the �nearest �health �center�and � in �part �by � the � fact� that �a � large �portion �of � the �population �cannot �pay � for �
the �cost �of �services. � �
Environmental � degradation � is � extreme � in � Haiti � and � has � a � significant � impact � on � the � availability � of � and �
access � to � potable �water, �which � constitutes � an � important � factor � for � health � and � the � spread � of � cholera. � �
Throughout �the �entire �country, �poor �waste �management �practices �and �the � lack �of �modern �sewerage �and �
sanitation �systems �are �among �the �environmental �factors �that �affect�the �health �of �the �population. � � �
Despite � the � cholera � epidemic � in � Latin � America � and � the � Caribbean � in � the � 1990s, � which � killed �
approximately �12,000 �people � in �21 �countries, � the � two �countries �of �Hispaniola �were � free �of �cholera �prior �
to � the � October � 2010 � outbreak. � The � epidemic � in � the � 1990s � was � finally � controlled � after � eight � years � of �
international � public � health � efforts � and � massive � investments � in � infrastructure,� water � supply, � and �
sanitation � in �the �region. �
1 Source : WHO/UNICEF Jo in t Moni to r ing P rogram, 2012 .
![Page 6: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/6.jpg)
II�Ͳ�EPIDEMIOLOGY�OF�THE�CHOLERA�EPIDEMIC�IN�HAITI�
The � cholera � epidemic � in �Haiti � began � in �October � 2010 � and �was � attributed � to �Vibrio � cholerae, � serogroup �
01, � serotype �Ogawa,�biotype �El �Tor. �The � first �case �was �detected � in � the �Central �Department, �after �which �
the � infection �spread �to �the �neighboring �department �(Artibonite) �before �spreading �gradually �to �the �other�
departments. � As�of� the� second�week�of�2013,� the�Ministry�of�Public�Health� and�Population�had� reported� a� total�of�
639,610�cases,�7,962�deaths,�and�353,288�hospitalizations.�Even � though � the � infection � spread � rapidly � across � the �
country, � it � is � interesting �to �note �that �two �geographic �areas�always �reported �more �cases �than �the �others:�
the �metropolitan �area �of �PortͲauͲPrince �and �the �neighboring �communes � in �the �Western �Department �and �
the �Artibonite �Department. �As �of �endͲDecember �2012, �those �departments �represented �26.9% �and �20.2% �
of � all � cases, � respectively. � The � overall � mortality � rate � is � estimated� at � 1.2%, � compared � to � 1.4% � for �
hospitalized �cases. �Figure �1 �below �shows �the �epidemiological �curve �for �the �period �from �20 �October �2010 �
to �8 �January �2013. �
�
6
![Page 7: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/7.jpg)
Cholera �Epidemic: �Situation �as �of �the �Second �Week �of �2013�New �Cases �Seen �and �Overall �Mortality
�
x From �the �42nd �week �of �2010 �to �the �2nd �week �of �2013, �the �Ministry �of �Public �Health �and �Population �reported: �
639,610 �cumulative �cases, �353,288 �hospital izations �(54% �of �cases �seen), �and �7,962 �deaths �(overall �mortality �of �1.2%), �of �which �5,090 �occurred � in �hospitals �(hospital �mortal ity �of �1.4%). �
x For �the �second �week �there �were �1,379 �cholera �cases, �905 �hospital izations, �and �24 �deaths, �20 �of �them � in � institutions �(overall �mortality, �1.7%; �hospital �mortality, �2.2%). �
x Did �not �report: �GrandeͲAnse. �
7
![Page 8: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/8.jpg)
Comparison�of�Cases�Seen�during�the�First�52�Weeks�of�2011�and�2012
8
![Page 9: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/9.jpg)
Trends�in�the�Incidence�of�Cholera�(from�the�42nd�epidemiological�week�of�2010�to�the�2nd�epidemiological�week�of�2013)�
9
![Page 10: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/10.jpg)
Total�Incidence�per�1,000�Population�by�Department�Haiti,�1st–2nd�Week,�2013���
Department�Total�Incidence�per�1,000�
Population�
Northwest� 2.8�
Grande�Anse� 3.5�
Nippes� 3.6�
Southeast� 4.2�
South� 6.4�
Artibonite� 8.8�
North� 10.5�
West� 10.9�
PortͲauͲPrince� 12.8�
Northeast� 18.7�
Central� 20.1�
Haiti� 10.1�
10
![Page 11: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/11.jpg)
III�Ͳ��OBJECTIVES�OF�THE�ACTION�PLAN�
a. Goal�of� the�Action�Plan�–�The�ultimate�goal�of� the�Action�Plan� is � to � eliminate � cholera � from � the � island � of �
Hispaniola � through � technical � and � financial � support � from � the � international � community � and �
binational �coordination. ��
b. Specific� Objectives� –� In � order � to � prevent � deaths � and � reduce � the � suffering � caused � by � the � cholera �
epidemic, � the � Haitian � government’s � main � strategy� is � to � put � in � place � an � integrated � approach � to �
prevent �and �stop�the �secondary �transmission �of �cholera � in �Haiti. � �
From � this �perspective, � the �Haitian �government �has �established � the � following � specific �objectives � to �
be �attained:�
i. Increase�access �to �potable �water �to �at � least �85% �of �the �population;��
ii. Increase�access �to � improved �sanitary �and �hygiene �facilities �to �at � least �90% �of �the �population;��
iii. Increase� collection � of � solid �waste � in � the �metropolitan � area � of � PortͲauͲPrince � to � 90% � and � in �
secondary �cities �to �80%;�
iv. Strengthen �the �public �health �system �to �facilitate �access �to �health �care �services�for �80% �of �the �
population;�
11
![Page 12: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/12.jpg)
v. Strengthen � epidemiological � surveillance � for � timely � detection � of � all � cholera � cases � and � other �
diseases �under �surveillance �through � improved � information�management;�
vi. Intensify � education � of � the � public � about � household � hygiene � and � an � understanding � of � food �
hygiene.�
IV�Ͳ�SHORTͲTERM�INTERVENTIONS�
The � National � Plan � for � the � Elimination � of � Cholera � calls � for � the � acceleration � over � the � first � two � years � of �
systematic � emergency �measures � at � the � level � of � the � plan’s � four � strategic � areas: � water � and � sanitation, �
management, �epidemiology, �and �health �promotion. � � It �was �thus �decided �that �the �shortͲterm �actions �will �
focus � on� preventing � the � transmission � of � cholera � from � one � person � to � another � through � the � use � of �
potable �water �for �consumption, �hand �washing, �and �food �handling.��
In�the�short�term,�the�Ministry�of�Public�Health�and�Population�will,�first,�undertake�the�following:�
a. Continue �with �emergency �measures �as �part �of �health �care �provision �and �with �treatment �with �the �
oral �rehydration �solution;�
b. Strengthen � the � network � of �multipurpose � community � health � agents � in � order � to � have � one � agent �
for �every�500 �to �1,000 �population � in �areas�at �risk �for �cholera. �During �the �course �of �the �epidemic,�
their �functions �will �be � l imited �to:�
12
![Page 13: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/13.jpg)
– Conducting �home �visits �targeting �households �where�there �are �suspected �cholera �cases;��
– Providing � regular� reports � to � the �Ministry � of � Public �Health � and � Population � about � detected �
cholera �cases;�
– Facilitating � the � treatment �of �persons � infected �with �cholera � following �ministry �protocol � for �
rehydration �with � the � help � of � oral � rehydration � solution, � accompanying � patients �when � they �
undertake �hygiene �and �sanitary �practices � in �order � to �protect �other �members �of � the � family, �
and, � when � necessary, � referring � patients � to � a � higher � level � of � care � in � the � health � system �
(cholera �treatment �centers, �health �centers,�or �communal �hospitals);�
– Promoting � and � supporting � efforts� by � the � population � to � follow � food � hygiene � measures �
according � to � the � directives � of � the � Ministry � of � Public � Health � and � Population � and � the �
National �Directorate �for �Water �Supply �and �Sanitation �(DINEPA);�
– Providing � health � education � and � promoting � hygiene � and � behavioral � changes � such � as � hand �
washing;�
– Carrying �out �chlorine �residue �tests �of �water �consumed � in �households �and �community �water �
pipe �systems;��
13
![Page 14: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/14.jpg)
– Administering � chlorine � (and/or � teaching � heads � of � families � how � to � add � chlorine) � to �
household �cisterns �for �drinking �water. ��
c. Coordinate �and � supervise � the �hygiene �and �health �education�messages � that �are �disseminated �by �
the � various � entities � involved � in � combating � cholera. � Ensure � that � the � community � health � agents�
and � personnel � from � nongovernmental � organizations � (NGOs) � are � sufficiently � trained � to � deliver �
messages � from � the �ministry � and �DINEPA � to � sensitize � the � population � about � the � risks � of � and � the �
protection �measures �against �cholera;�
d. Ensure � that � all � health � professionals � are � trained � in � the � fundamentals � of � combating � cholera � and �
that � they � promote � through � their� own � daily � practices � the � messages � that � champion � access � to �
potable �water, � sanitation, � and � hygiene � in � health � centers � and � community � clinics, � and � at � public �
awareness �events;��
e. Establish � a � network � of � community � health � clubs � to � increase � efficiency � and � reduce � the �workload �
of �the �community �health �agents; �
f. Establish � local �community �health �clubs � throughout � the �country � (run �by �health �workers) � in �order �
to �promote �hygiene �and �other �public �health � issues; �
g. Vaccinate�the�population� in�atͲrisk�or�stillͲvulnerable�areas� (30�to�40�percent�of�the�population;�approximately�
600,000�people).�
�
14
![Page 15: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/15.jpg)
Secondly,�DINEPA�will:��
h. Continue �with �emergency �measures �for �the �provision �of �safe �water � in �areas �at �risk �of �cholera, �as �
well � as � with � the � installation � of � excreta � disposal � systems� for � hospitals, � health � centers, � and �
households �that�need �them; ��
i. Coordinate �DINEPA � interventions �with � those � of � the �Ministry � of � Public �Health, � concentrating � on �
emergency �actions � in �areas �being �handled �by �community �health �agents; ��
j. In� collaboration� with� the� Ministry� of� Public� Health� and� Population,� ensure� that� residents� of� communities�
identified�as�being�at�risk�for�cholera,�and�that�do�have�access�to�safe�drinking�water,�have�access�to�consumable�
water�through�the�appropriate�use��of�chlorine�liquid�or�tabs;�
k. Coordinate�with� the�Ministry�of�Public�Health�and�Population� in� the� training�of�community�health�agents�and�
municipal� sanitary� technicians,� including� training� on� water� conservation,� promotion� of� hygiene,� and� water�
analysis�and�an�understanding�of�chlorine�production�equipment.��
V�Ͳ��EXPECTED�RESULTS�
1. The � risk � of � transmission � of � Vibrio � cholerae � by � using � water � that � is � insufficient � in � quality � and �
quantity � is � eliminated � through � repairs � to � existing � networks � and � the � construction � of � new �water �
supply � systems � in � all �mediumͲsize � or � large � cities � (that � do � not � currently � have �water� supply), � as �
well �as � in �rural �agglomerations �judged �to �be �a �priority;��
15
![Page 16: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/16.jpg)
2. The � risk �of � transmission �of �Vibrio � cholerae �due � to �poor �disposal � and �management �of � excreta � is �
eliminated �from �the �entire �national �territory �through �the �promotion �of �sanitary �excreta �disposal �
systems, � in � situ, � in � urban � and � rural � areas, � as � well � as � the � construction � of � sanitary � sewerage �
accompanied �by �wastewater �treatment �systems � in �certain � large �cities �and �treatment �systems �for �
sludge � in �other�mediumͲsized �cities; �
3. The � institutional � capacity � of � DINEPA � is � strengthened � at � the � national � level � and � in � its �decentralized �structures. �
�
VI�Ͳ�INDICATORS�
BY�THE�END�OF�2015:������ Ͳ�� The�annual�cholera�incidence�rate�in�Haiti�is�reduced�from�3%�to�ч�0.5%�
����������� Ͳ�� 80%� of� the� population� living� in� areas� of� the� country� where� there� is� active� secondary�
transmission���of�cholera�washes�their�hands�after�defecating�and�before�eating��
VII�Ͳ�ACTIVITIES�AND�COST�OF�IMPLEMENTING�THE�ACTION�PLAN�
The� activities� of� the� different� Action� Plans � are� shown� in� the� table� below,�which� follows � the� four � areas�
defined�for�the�project:�water�and�sanitation,�health�services�and�health�care�management,�epidemiology, �
and�the�promotion�of�health,�hygiene,�and�nutrition.� In�the�table�the�activities �are�grouped�under� lines�of�
16
![Page 17: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/17.jpg)
action� to � be� undertaken� to� achieve� the� defined� objectives.� The� total � cost � for � implementat ion � of � the �
Action �Plan � for �2013–2015 � is �est imated �to �be �US$443,723,100.��
�
VIII�–�MONITORING�AND�EVALUATION�
FollowͲup � of � implementation � of � the � Action � Plan � will � be � the � responsibility � of � a � Steering � Committee �
comprised �of �representatives � from �the �ministries � involved �and �technical �and � financial �partners. �The �role �
of � the � committee � is � to � facilitate � the � coordination � of � policy � and � strategy.� It � is � desirable � to � have �
participation � by � the � Ministries � of � Public � Works, � Public � Health, � Education, � Communications, � the �
Environment, � and � the � Interior � and � Local � Communities. � The � committee � will � meet � twice � a � year � and �
whenever �else �the �representative �of �one �of �the �executing �agencies �(DINEPA, �Ministry �of �Health, �Ministry �
of � Transport � and� Public �Works, �Ministry � of � the � Interior � and � Local � Communities) � calls � for � convoking � a �
meeting.�
Operational � implementation �of � the �Action �Plan �will �be �supervised �by �a �Technical �Committee �made �up �of �
highͲ level � officials � from � DINEPA, � the �Ministry � of � Public � Health, � the �Ministry � of � Public �Works, � and � the �
Ministry �of �the � Interior, �as �well �as �representatives �from � international �agencies �cooperating � in �one �of �the �
Action �Plan �areas. �The �DirectorͲGeneral �of �the �Ministry �of �Public �Health �or �his �designated �representative �
will �preside �over�this �committee.�
17
![Page 18: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/18.jpg)
The � Technical � Committee � will � meet � quarterly � in � order � to � review � progress� in � implementation � of � the �
Action � Plan, � propose � corrective �measures � as � needed, � and � prepare � reports � for � the � Steering � Committee. �
The �members � of � the � Technical � Committee �will � carry � out � field � visits � as � needed � in � order � to � evaluate � the �
results �of �the �project.��
An � evaluation � of � implementation� of � the � Action � Plan � will � be � undertaken � at � the � end � of � each � year. �
Similarly, � an � audit �will �be � conducted � at � the �halfway �point � and � at � the �end �of � the �plan’s � implementation �
period.�
�
18
![Page 19: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/19.jpg)
IX�–�PLAN�OF�ACTION�(SUMMARY),�SHORTͲTERM,�2013–2015/FINANCING�REQUIRED�YEARS� FINANCING�IN�US$�SPHERE�
OF��ACTIVITY�
EXECUTING�AGENCIES�AND�AREAS�OF�INTERVENTION� 2013Ͳ2015� 2013Ͳ2015� YEAR�1�
EXPLANATORY�NOTES�(Expected�Results)�
ѕ�DINEPA� � 91,481,000� 33,075,000� �
��Ͳ��Drinking�water�supply�� X� 50,560,�000� 15,720,000� DINEPA�and�its�decentralized�structures�are�strengthened�
��Ͳ��Treatment�of�wastewater�and�excreta� X� 22,700,000� 10,450,000� Activities�of�the�water�supply�and�sanitation�sector�are�coordinated,�monitored,�and�regularly�evaluated�
��Ͳ�Institutional�strengthening�of�DINEPA�� X� 18,221,000� 6,905,000�Cities�and�towns�benefit�from�wastewater�collection�and�treatment�service�that�complies�with�social�and�environmental�standards��
ѕ�Ministry�of�Public�Works,�Transport,�and�Communications/Ministry�of�the�Interior�and�Local�Governments��
� 231,500,000� 1,500,000� �
��Ͳ�Institutional�strengthening�of�solid�waste�management�
X� 1,500,000� 1,�500,000� Access�to�water�supply�is�improved�throughout�the�country�
ARE
A�
WATER�AND�SANITATION�
��Ͳ�Waste�collection�and�treatment��� X� 230,000,000� � Each�Region�has�at�least�one�excreta�treatment�site�
ѕ�Ministry�of�Health� � 94,518,100� 81,�473,000� �
��Ͳ�Health�care�services�� X� 39,694,100� 26,�649,000� Management�of�diarrheal�diseases�improved�and�completely�adequate�
��Ͳ�Inputs/Essential�medicines�� X� 54,824,000� 54,824,000� By�2015,�all�inputs�are�available�in�sufficient�quality�and�quantity��
��Ƒ�Epidemiology�� � 4,350,000� 4,�200,000� �
��Ͳ�Quality�of�information� X� 1,350,000� 1,200,000� Strengthening�of�epidemiological�surveillance�with�a�view�toward�rapid�and�concerted�action�
��Ͳ�Research�capacity� X� 3,000,000� 3,000,000� Effective�epidemiological�surveillance�with�strengthening�of�microbiological�and�environmental�surveillance�
Ƒ��Health�Promotion� � 26,324,000� 37,678,000� �
��Ͳ�Hygiene�practices�� X� 3,580,000� 11,590,000� Understanding�and�skills�in�cholera�prevention�measures�promoted�among�the�population�at�risk��
��Ͳ�Institutional�strengthening� X� 8,010,000� 4,154,000� Strengthened�vigilance�by�the�population�in�the�face�of�the�country’s�cholera�threat�
��Ͳ�Food�hygiene� X� 1,240,000� 1,240,000�Food�hygiene�practices�strengthened�in�areas�at�risk�for�cholera�in�order�to��reduce�the�incidence�of�nutritional�and�diarrheal�illnesses���
��Ͳ�Micronutrient�deficiency� X� 9,340,000� 18,540,000� Fight�against�micronutrient�deficiencies�strengthened�in�areas�vulnerable�to�cholera�
ARE
A��O
F�PU
BLIC�HEA
LTH�
��Ͳ�Hospital�hygiene�� X� 4,154,000� 2,154,000� Environmental�protection�in�health�institutions�strengthened�
� ѕ�COUNTRY�TOTAL�� 443,�723,100� 157,�926,100� �
19
![Page 20: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/20.jpg)
STRATEGIC�INTERVENTION�FRAMEWORK��
���������SPHERE�OF�ACTIVITY:���WATER�AND�SANITATION��� � ������COMPONENTS:��
o STRENGTHENING�DINEPA�o ACCESS�TO�POTABLE�WATER�o ACCESS�TO�SANITATION�
�
ACTIVITIES� INDICATORS�FOR�ACTIVITIES�� BASEYEARS�1�AND�2�
FOR�YEAR�1� EXPLANATORY�NOTES�
1.�Organization�of�sectoral�governance.� Number�of�new�Technical�
Center�Operations�(CTE)�in�20 15� 1,�000,000
US$100,000�per�CTE.��
SPHERE:�WATER�SUPPLY�AND�SANITATION � ���COMPONENT:�STRENGTHENING�DINEPA
20
![Page 21: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/21.jpg)
21
ACTIVITIES� INDICATORS�FOR�ACTIVITIES�� BASEYEARS�1�AND�2�
FOR�YEAR�1� EXPLANATORY�NOTES�
place�and�operational�Number�of�new�Water �Supply �and �Sanitation �Committees �(CAEPA)�in�place�and�operational�
90 30� 400,000
Number�of�Communal�Administrative�Councils�(CASEC)�actively�involved�in�the�water�supply�and�sanitation�sector��
0 30� 5,000
Number�of�school�inspectors�actively�involved�in�monitoring�the�Alliance�for�Water,�Sanitation,�and�Hygiene�in�School�(EAHMS)�
0 500� 5,000
Number�of��Multipurpose�Community�Health�Agents�actively�involved�in�the�water�supply�and�sanitation�sector�
0 500� 10,000
Number�of�localities�recorded� 0 ?� 1,000,000Number�of�base�maps�completed�and�regularly�updated�
0 1� 5,000
Number�of�water�point�outlets�geoͲreferenced�
0 ͲͲͲͲͲ� 50,000
Coordination�and�control�of�all�actors�intervening�in�the�sector�across�the�country�through:�
- Guidance�and�support�for�new�structures,�prioritizing�sensitive�areas�(CTE,�CAEPA)�- information�meetings�and�workshops�with��partners�and�local�authorities�(CASEC,�school�inspectors,�multipurpose�community�health�agents,�CAEPA)�- Establishment�of�an�exhaustive�database�on�support�to�the�water�supply�and�sanitation�sector�- Coordination�meetings�and�workshops�at�all�levels�(national�and�regional�sector�tables,�sanitation�platform,�WASH�cluster,�coordination�of�collection)�
���
Number�of�annual�coordination�meetings�held�
24 36�
Establishment�of�a�followͲup�and�evaluation�system.�Development�of�
Number�of�evaluation�tools�in�place� 0 1�
50,000
US$20,000�per�CAEPA.��At�least�90�CAEPA�will�be�operational�in�2022.��The�base�map�shows�the�water�supply�and�sanitation�situation�of�a�group�of�localities�and�a�communal�section.��The�evaluation�tool�allows�for�understanding�and�analyzing�the�progress�of�water�supply�and�sanitation�activities�in�real�time.���An� autonomous� system� linked� to� the�prevalence�of�cholera� should�be� in�place�in� order� to� ensure� the� followͲup� and�evaluation� of� immediate� responses�planned�and�implemented.�
![Page 22: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/22.jpg)
22
ACTIVITIES� INDICATORS�FOR�ACTIVITIES�� BASEYEARS�1�AND�2�
FOR�YEAR�1� EXPLANATORY�NOTES�
decisionͲmake�tools,�holding�of�evaluation�sessions.��
Number�of�evaluation�sessions�carried�out� 0 4�
1.1 Result�Water�supply�and�sanitation�known�and�regularly�updated�
1.2�Result�Water�supply�and�sanitation�sector�activities�coordinated,�monitored,�and�regularly�evaluated�
Percent�of�the�population�benefiting�from�the�support�of�local�authorities�� � �
2,525,000
Number�of�procurement�specialists�recruited�by�DINEPA�to�strengthen�this�service�in�order�to�ensure�implementation�of�the�Plan��
0 6� 144,000
Two�persons�to�be�recruited�for�rapid�actions�at�the�central�level�and�one�person�by�OREPA�for�arrangement�and�followͲup�of�small�local�contracts.���Estimated�cost�of�US$2,000�x�6�per�month�
2.Ͳ�Strengthening�of�DINEPA�structures�Recruitment�of�qualified�staff�to�strengthen�the�water�supply�and�sanitation�response�at�the�national�level�Ͳ�Additional�staff�for�DINEPA�headquarters�and�decentralized�structures.�Ͳ�Staff�attached�to�sanitation�at�the�central�level�and�in�the�regional�water�supply�and�sanitation�offices�(OREPAs)�
Number�of�sanitation�staff�in�place��
8 12� 144,000
Ͳ��Recruitment�of�staff�for�the�response�structure�during�the�dry�season�
Number�of�water�supply�technicians��recruited�for�the�response�during�the�dry�season�
0 3� 144,000
Ͳ���Payment�for�TEPACs�as�of�2013�Number�of�operational�TEPACs�
258 280� 906,000
12�staff�members�paid�an�average�of��US$2,000��Three�technicians�paid�an�average�of��US$2,000��280�community�water�supply�and�sanitation�technicians �(TEPACs) �x�18�months�x�$500�+�22�x�6�months�x�$500)��
![Page 23: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/23.jpg)
23
ACTIVITIES� INDICATORS�FOR�ACTIVITIES�� BASEYEARS�1�AND�2�
FOR�YEAR�1� EXPLANATORY�NOTES�
Ͳ� Training� of� staff� at� DINEPA�headquarters�
Number�of�staff�trained�in�sanitation�
10 25�
Ͳ� Technical� training� of� staff� from�OREPAs,�CTEs,�and�CAEPAs��
Number�of�OREPA,�CTE�and�CAEPA�staff�trained���
10 2,550�
Ͳ�Ongoing�training�of�sanitary�officers,�health�agents,�and�school�inspectors�on�topics�linked�to�water�supply�and�sanitation��
Number�of�sanitary�officers�and��multipurpose�community�health�agents�trained�
500 200�
10,000 Over�two�years��
2.1�Result:�Water�supply�and�sanitation�staff�strengthened� � � 1,348,000� �
3.�Support�for�innovation�Ͳ�Feasibility�studies�on�the�provision�of�potable�water�through�the�use�of�surface�water�
Number�of�feasibility�studies�completed��
2 �
Ͳ�Studies�related�to�sanitation� Number�of�studies�launched� � �
2,000,0005�million�Haitians�live�in�rural�areas,�so�increasing�coverage�by�10%�comes�to�$50�million�
ͲTechnical�assistance�in�sanitation� International�personnel�maintained�in�their�posts� � �
96,000
3.1�Result:�Studies�conducted�and�concluded� � � 2,096,000�
SUBTOTAL:�Institutional�Strengthening�of�DINEPA�� �
6,905,000�
�
�
�
�
![Page 24: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/24.jpg)
�
�
ACTIVITY� INDICATORS�FOR�ACTIVITIES� BASE� YEARS�1�AND�2� FOR�YEAR�1� EXPLANATORY�NOTES��
1.�Construction,�rehabilitation,�expansion,�and�maintenance�of�water�supply�systems�- In�the�area�of�metropolitan�PortͲauͲPrince�
Number�of�additional�systems�built���
ͲͲͲ ͲͲͲ
- In�mediumͲsized�cities�and�small�urban�centers�
Number�of�production�systems�completed�or�expanded��
ͲͲͲ ͲͲͲ
- In�rural�areas�Number�of�new�and�operational�rural�potable�water�supply�systems��
ͲͲͲ
10,000,000�
�1.1Ͳ Result:�2%�of�new�homes�in�the�metropolitan�area�of�PortͲauͲPrince�are�equipped�with�a�potable�water�system��%�of�homes�with�access�to�potable�water�in��the�metropolitan�area�of�PortͲauͲPrince�
50% 52%
Result:�13.5%�of�new�homes�in�15�mediumͲsized�cities�(30,000�to�100,000�inhabitants)�and�23�small�urban�centers�(between�10,000�and�30,000�inhabitants)�are�equipped�with�a�potable�water�system�%�of�homes�with�access�to�potable�water�in�24�secondary�cities�
10,000,000�
Populations�that�currently�have�access�only�to�river�water�benefit�from�priority�interventions�that�enable�them�to�have�access�to�potable�water�(treatment�networks,�boreholes,�or�stations�for�potable�water�in�households,�etc.)�
WATER�SUPPLY�AND�SANITATION ���������������������� ��COMPONENT:�ACCESS�TO�POTABLE�WATER
24
![Page 25: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/25.jpg)
25
ACTIVITY� INDICATORS�FOR�ACTIVITIES� BASE� YEARS�1�AND�2� FOR�YEAR�1� EXPLANATORY�NOTES��
1.2Ͳ Result:�7%�of�new�homes�in�rural�areas�(towns�of�3,000�to�10,000�inhabitants�and�localities�of�less�than�3,000)�have�access�to�a�potable�water�system�%�of�homes�in�rural�areas�with�access�to�potable�water��
53% 60%
Number�of�new�sources�where�the�perimeter�is�clean�
ͲͲͲ ͲͲͲ
�
Number�of�new�sources�where�the�perimeter�is�protected�
ͲͲͲ ͲͲͲ
�
Number�of�networks�providing�chlorinated�water�
ͲͲͲ ͲͲͲ�
2.�Preparation�and�implementation�of�a�water�quality�control�program�including:�- Cleaning�of�perimeters�of�collection�sources�(2�x�4�OREPAs)�
- Construction�of�protection�perimeters�
- Chlorination�of�100%�of�existing�networks�
- Making�water�treatment�products�available�in�identified�localities��
Number�of�distribution�centers�for�treatment�products�in�place�
ͲͲͲ 100
1,000,000�
�
2.1Ͳ�Result:�Populations�that�currently�have�access�only�to�river�water�benefit�from�immediate�priority�interventions�that�enable�them�to�have�access�to�household�potable�water�systems��%�of�the�population�having�access�to�water�of�which�the�quality�is�guaranteed�
ͲͲͲ 100% 1,000,000
�
![Page 26: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/26.jpg)
26
ACTIVITY� INDICATORS�FOR�ACTIVITIES� BASE� YEARS�1�AND�2� FOR�YEAR�1� EXPLANATORY�NOTES��
3.�Preparation�and�implementation�of��water�supply�and�sanitation�responses�in�emergency�situations�
Number�of�response�actions�by�the�Department�of�Emergency�Response�(DRU)�or�by�humanitarian�organizations�following�a�catastrophe�
ͲͲͲ ͲͲͲ 720,000
DRU�staff�$20,000/month,�financed�until�June�2013�by�the�World�Bank.���$10,000/month�planned�to�finance�the�interventions.�Technical�assistance�$40,000/month.�
3.1�Result:�A�response�structure�during�the�dry�season�is�established�by�teams�from�the�Ministry�of�Health�and�DINEPA.�3.2�Result�2:�Areas�identified�as�residual�sources�of�transmission�areas�benefit�from�an�immediate�and�conclusive�technical�response.�3.3�Result�3:�100%�of�areas�declared�as�residual�outbreaks�have�benefited�from�control�actions�from�water�supply�points��%�of�the�population�living�in�former�residual�source�areas�benefit�from�potable�water��
ͲͲͲ� 100%� 4,720,000�
�
SUBTOTAL:�Access�to�Potable�Water�� �
15,720,000�
�
![Page 27: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/27.jpg)
�
�
�
WATER�SUPPLY�AND�SANITATION ��COMPONENT:�TREATMENT�OF�WASTEWATER�AND�EXCRETA
ACTIVITY� INDICATORS�FOR�ACTIVITIES� BASE� YEARS�1�AND�2� FOR�YEAR�1� EXPLANATORY�NOTES�
1.�FollowͲup�of�sanitation�activities�and�support�for�local�governments:��
- Continued�support�costs�for�training�300�TEPACs�
- Equipping�local�governments�for�inspection�and�followͲup�of�sanitation�actions�
Number�of�local�governments�benefiting�from�support�for�improved�involvement�in�wastewater�management�
0 20� 100,000
- Training,�materials�and�communication�tools�for�the�CASECs�
Number�of�CASECs�active�in�promoting�sanitation��
0 20� 50,000
20�total�local�governments�(….�intermediate�cities,�…..�secondary�cities,…..rural�localities)�are�already�programmed,�20�other�local�governments�identified�by�the�Ministry�of�Health�will�need�to�be�added�to�the�list�of�priorities�on�the�basis�of�cholera�residue.���However,�the�group�of�local�governments�will�be�reached�through�the�TEPACs�to�ensure�and/or�strengthen�planning�of�future�actions�to�monitor�those�in�progress.��
1.�Result:�Local�officials�involved�in�wastewater�management�and�in�effective�followͲup�of�the�sector.�
%�of�the�urban�population�benefiting�from�support�and�followͲup�by�local�officials�responsible�for�wastewater�management.�
150,000
�
27
![Page 28: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/28.jpg)
2.�Preparation�and�implementation�of�a�Sanitation�and�Hygiene�Promotion�Plan�(PAH)��Communication�and�Promotion�of�Awareness��- Development�and�dissemination�of�educational�materials��
Number�of�teaching�kits�designed/prepared�and�disseminated�for�use�with�the�different�targeted�groups��
6 6�
Target�groups:�schools,�regional�and�local�markets,�other�public�spaces�(sports�facilities,�stations,�etc.),��religious�festivities�and�other�events��where�large�numbers�of�people�gather,�health�centers�
- Carrying�out�campaigns�in�cities�
Number�of�campaigns�carried�out�in�cities�
0 3� 8�annual�campaigns�by�cities���
- Integration�of�CAEPAs�in�the�promotion�of�sanitation�and�hygiene�
Number�of�CAEPAs�benefiting�from�a�sanitation�focal�point�
Each�CAEPA�will�be�assigned�to�designate�a�sanitation�focal�point���
- Preparation�of�an�appropriate��film�documentary���
Extent�of�the�dissemination�of�the�documentary�film��
30 30�Film�to�sensitize�the�public�at�large�about�the�situation�regarding�cholera�prevention�and�control.��
- Competitions�about�safety��between�groups�from�different�localities,�through�CASECs�and�CAEPAs�
Number�of�competitions�held� 0 10�Competitions�in�Artibonite,�the�Northeast,�and�the�Central�Departments�for�a�total�of�10�networks�
Training�- Training�and�use�of�multipurpose�community�health�agents�in�the�PAH�
Number�of�health�agents�identified�and�working�actively�in�the�PAH��
1,500 3,000�1�agent�for�an�average�of�3�localities,�or�1�agent�per�1,000�habitants�in�rural�areas�
- Training�of�masons�in�cities�and�localities�involved�
Number�of�masons�trained�� 0 100�
2,000,000
An�average�of�3�masons�in�secondary�cities�
28
![Page 29: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/29.jpg)
- Support�for�trained�masons��
Number�of�trained�masons�known�in�their�localities��
� ��
Result:�Population�reached�by�key�sanitation�messages�%�of�the�urban�population�that�has�access�for�the�first�time�to�household�sanitation��through�the�zero�subsidy�approach� 80% 82%� �
Result:�Rural�population�sensitized�about�the�need�to�use��adequate�sanitary�facilities�for�defecation�(%�of�the�rural�population�with�access�to�a�household�sanitary�facility)�
50% 55%�
2,000,000
�
Number�of�sewerage�networks�regarding�which�studies�are�conducted�
1 3� 1,000,000
Number�of�sewerage�networks�for�which�construction�is�undertaken�
0 2� 1,000,000
Number�of�new�excreta�treatment�stations�built�to�standards�
2 6� 1,200,000
Construction�of�semiͲcollective�sewerage�networks�and�wastewater�treatment�stations�in�the�main�cities�in�the�country�(25):��- Study��- Construction��- Control�and�FollowͲup��- Environmental�and�social�standards�� Number�of�bayakous�formalized� 0 3� 100,000
�
In�2022,�studies�will�be�completed�in�15�of�the�30�cities�with�more�than�30,000�inhabitants��
In�2022,�stations�will�be�built�in�at�least�25�cities�
In�2022,�at�least�3�bayakous�per�city�of�at�least�300,000�inhabitants�will�be�formalized�
Construction,�repair,�management,�and�maintenance�of�public�toilets:��- In�schools�
Number�of�public�or�mixed�schools�equipped�with�adequate�sanitary�facilities�
460 1,000� 5,000,000
In�2022,�all�public�schools�will�have�adequate�sanitary�facilities�regularly�used�by�the�beneficiaries�
29
![Page 30: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/30.jpg)
30
Number�of�markets�equipped�with�adequate�sanitary�facilities�
0� 100�
241� 500�
- In�other�public�areas�
Number�of�public�or�mixed�health�centers�equipped�with�adequate�sanitary�facilities�Number�of�other�targeted�public�areas�equipped�with�adequate�sanitary�facilities�
0� 100�
The�unit�cost�per�public�location�is�between�$10,000�and�$40,000�depending�on�the�intervention�required,�that�is,�construction�or�repair�
Result:�Cities�and�towns�benefiting�from��wastewater�treatment�and�disposal�services�that�are�in�accordance�with�social�and�environmental�standards��
Impact:�%�of�the�total�population�that�benefits�from�a�healthy�environment�
8,300,000�
Each� Region� has� at� least� one� excreta�treatment�site���
SUBTOTAL:�Treatment�of�Wastewater�and�Excreta�� �
10,450,000��
![Page 31: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/31.jpg)
INDICATORS�OF�ACTIVITIES�ACTIVITIES�
ACCORDING�TO�THE�ACTION�PLAN� FOR�YEAR�1�
SUBTOTAL:��Institutional�Strengthening�of�DINEPA� 74,000,000 6,905,000�
SUBTOTAL:�Access�to�Potable�Water� 81,000,000 15,720,000�
SUBTOTAL:�Treatment�of�Wastewater�and�Excreta� 59,600,000 10,450,000�
GRAND�TOTAL� 214,600,000 33,075,000�
31
![Page 32: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/32.jpg)
STRATEGIC�INTERVENTION�FRAMEWORK��
SPHERE�OF�ACTIVITY:�PUBLIC�HEALTH��
COMPONENTS:��
o HEALTH�CARE/MANAGEMENT�o MEDICINES/INPUTS�o EPIDEMIOLOGICAL�SURVEILLANCE�o HYGIENE�PRACTICES��
��
����SPHERE:��HEALTH�CARE������������������������������ ������������������������������ �����������COMPONENT:�MANAGEMENT
INDICATORS:��By�2015,�there�are�no�more�deaths�from�cholera�in�public�or�private�health�institutions�or�facilities,�with�the�exception�of�cases�associated�with�other�illnesses.���
32
![Page 33: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/33.jpg)
33
YEARS�1�AND�2��RESULTS�
�ACTIVITIES�
2013/2014� 2014/2015�
FINANCING�2013Ͳ2015�
�EXPLANATORY�NOTES�
1.1.�Organization�of�community�meetings�to�transfer�knowledge�about�management�to�community�leaders��
X� X� Community�involvement�in�combating�cholera�in�the�10�departments�
1.2.�Organization�of�home�visits�by�health�agents�� X� X�Home�visits�in�vulnerable�areas��
1.3.�Training�of�field�agents�in�prevention�and�management�of�diarrheal�diseases���
X� X�
1.4.�Training�of�technical�and�support�staff�(health,�brigadiers��and�rapid�intervention��brigades,�560�people�and�teams�for�the�10�departments)�
� �
1.5.�Preparation�of�a�contingency�plan�by�commune� X� X�
1.6.�Support�for�training�and�organization�of�the�community�for�surveillance�of�the�ongoing�availability�of�inputs�at�the�local�level�
X� X�
1,500,000��
Providers�(6,000)�will�be�trained�in�cholera�management�
1.7.�Establishment�of�oral�rehydration�points�(PRO+)�in�areas�without�sanitary�facilities�and�that�are�difficult�to�access�(365)�
X� X�
�Management�of�diarrheal�diseases�significantly�improved�and�completely�adequate��
1.7ͲIdentification�and�regular�control�of�stock,��positioning�of�inputs�in�appropriate�locations�at�the��departmental�and�communal�levels�
X� X�
2,000,000�
Artibonite:�63;�Northeast:�27;�Northwest:�7;�Central:�30;�Grande�Anse:��47;�West:��80;�Nippes:�32;�South:�24;,�North:�40;�Southeast:��15��
![Page 34: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/34.jpg)
34
YEARS�1�AND�2��RESULTS�
�ACTIVITIES�
2013/2014� 2014/2015�
FINANCING�2013Ͳ2015�
�EXPLANATORY�NOTES�
1.8.�Construction/placement�of�locations�for�management�of�patients�with�diarrhea�in�health�facilities�(infectious�disease�management�unit)�
X� X� 3,000,000
Departmental�hospitals:��10�Community�reference�hospitals:��30��Health�centers�without�beds:�…�Health�centers�with�beds:�…�
1.9.�Establishment�of�emergency�funds�at�the�departmental�level� X� X� 3,325,000
Funds�to�be�made�available�to�10�BD�to�enable�the�DD�to�address�outbreaks�
1.10.�Harmonization�of�standards�for�the��construction�of�cholera�treatment�centers�in�health�centers�and�hospitals�� X� X� Leadership�of�the�Organization�of�Health�
Services�will�be�involved�
1.11.�Development/standardization�and�dissemination�of�standards�and�procedures�for�the�prevention�of�infection�in�health�facilities�������� �
X��X�
1.12.��Development,�standardization,�and�dissemination�of�standards�for�the�handling�of�cadavers����
X� X�
5,000,000
This�activity�will�be�carried�out�at�the�central�level�
1.13.��Hiring�of�additional�staff��(1,099�health�professionals)�needed�in�institutions�
X��
X��
5,000,000�266�nurses,��400�auxiliaries,��133�doctors,�20�laboratory�technicians��
![Page 35: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/35.jpg)
35
YEARS�1�AND�2��RESULTS�
�ACTIVITIES�
2013/2014� 2014/2015�
FINANCING�2013Ͳ2015�
�EXPLANATORY�NOTES�
1.14.�Supervision:�application�of�standards�for�management,��decontamination,�and�verification�of�alerts��
�
X� X� Supervision�will�be�at�several�levels�and�several�groups�will�be�involved��
1.15.�Response�to�alerts�in�the�event�of�outbreaks� X� X�
660,000
Management�of�outbreaks�
SUBTOTAL� 20,485,000 �
![Page 36: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/36.jpg)
YEARS�1�AND�2� FINANCING�RESULTS� ACTIVITIES�
2013/2014� 2014/2015� 2013Ͳ2015�EXPLANATORY�NOTES��
2.1.�Operationalization�of�the�vaccination�plan� X� �
2.2.�Design�and�production�of�management�tools�(vaccination�cards,�registration�forms,�recordͲkeeping�forms,�etc.)�
X� �
2.3.�Identification,�microͲplanning,�and�eventually�the�preregistration�of�beneficiaries�� X� �
2.4.�Training�of�providers� X� �
2.5.�Communications�and�social�mobilization�activities�(radio�and�television�spots�banners,�posters,�community�meetings,�launch�activities,�etc.)
X� �
2.6.��Strengthening�the�logistics�of�the�cold�chain�X� �
2.7.�Operations�(the�actual�vaccinations)�X� �
2.8.�FollowͲup�and�evaluation� X� �
6,164,100Strengthening�of�departments�in�terms�of�materials�and�staff.�Purchase�of�vaccines�and�inputs.
�2Ͳ�Reduction�in�the�incidence�of�cholera�through�the�targeted�areas���
SUBTOTAL� 6,146,1000
GRAND�TOTAL� 26,649,100
SPHERE:�HEALTH�CARE������������������������������ ��������������������� �������������������� �COMPONENT:�VACCINATION
36
![Page 37: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/37.jpg)
INDICATOR:�By�2015,�all�inputs�are�available�in�sufficient�quantity�and�quality.�
YEARS�1�AND�2� FINANCING�RESULTS� ACTIVITIES�
2013/2014� 2014/2015� 2013Ͳ2015�EXPLANATORY�NOTES��
3.1.�Standardization�of�tools�for�the�management�of�cholera�inputs� X� X�
3.2.�Updating,�disclosure,�and��application�of�standards�(signing�of�a�protocol�agreement�and�a�convention�protocol)�
X� X�
3.3.�Updating�of�the�information�database/uniformity�of�management�tools/implementation�of�Channel�software�
X� X�
3.4. Supervision�and�awareness�spots� X� X�
360,000
�
3.5. Purchase�of�medicines�and�inputs�to�support�health�institutions�in�emergency�responses�linked��to�cholera�
X� X� 50,000,000Purchase�of�Lactated�Ringer’s�solution,�antibiotics,�chlorine�products,�and�necessary�materials�
3.6. Human�resource�needs�–�Recruitment�of�staff�� X� X� Pharmacists�(13),�secretaries�(2),�and�other�staff�(5)�
�3.�Improved�logistics�to�make�inputs�and�medicines�available�and�accessible�to�health�centers�for�the�timely�handling�of�cholera�cases��
3.7. Strengthening�the��Ministry’s�supervisory�capacity�of�the�Center�for�the�Distribution�and�Supply�of�Inputs�(CDAI)�(vehicles,�cargo�trucks,�etc.)�
X� X�
1,464,000
�
SPHERE:�HEALTH�CARE����������������� �������������������������������� ����������������COMPONENT:�MEDICINES/INPUTS
37
![Page 38: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/38.jpg)
3.8. Training�of�managers�in�the�use�of�stock�management�tools�
X� X�
3.9. Creation�and�operation�of�a�pharmacovigilance��unit�
X� X�
3.10. Coordination�meetings�with�partners� X� X�
3.11. Construction�and�rehabilitation�of�the��CDAI� X� X� 3,000,000 �
SUBTOTAL�� �
54,824,000 �
38
![Page 39: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/39.jpg)
INDICATOR:�Epidemiological�surveillance,� including�microbiological�and�environmental�surveillance,� is�carried�out�at�the�national� level�and� in�100%�of�the�targeted�areas�as�of�2014.�
YEARS�1�AND�2� FINANCING��RESULT�
�ACTIVITIES�
2013/2014� 2014/2015� 2013Ͳ2015�
�EXPLANATORY�NOTES�
4.1.�Acquisition�of�information�technology�equipment�and�materials� X�
4.2.�Communications�management�support�system�(telephone,�Internet)�
�X�
4.3.�Logistical�support�(vehicles,�maintenance,�and�repairs)� X�
�Availability�of�materials�and�equipment�for�better�information�management�
4.4.�Support�staff�to�strengthen�the�team���
850,000
Institutional�strengthening��
4.5.�Preparation�of�a�list�of�illnesses�under�surveillance� X�
4.6.�Workshops�on�the�validation�of�information� �
4.7.�Daily�verification�and�weekly�analysis�of�alerts� X�
4.�Strengthening�of��epidemiological�surveillance�(including�microbiological�and�environmental�surveillance�in�collaboration�with�DINEPA)��as�a�result�of�adequate�training,�early�detection�of�cases,��and�timely�alerts�at�the�departmental�and�national�levels�with�a�view�toward�rapid�and�concerted�action�
4.8.�Development�of�tools�for�surveillance��by�communities�� X�
100,000
Ensure�better�information�management�for�decisionͲmaking�
SPHERE: EPIDEMIOLOGICAL�SURVEILLANCE� ��������������COMPONENT:�QUALITY�OF�INFORMATION
39
![Page 40: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/40.jpg)
40
YEARS�1�AND�2� FINANCING��RESULT�
�ACTIVITIES�
2013/2014� 2014/2015� 2013Ͳ2015�
�EXPLANATORY�NOTES�
4.9.�Revised�training�manual�for�health�agents�available�
X��
4.10.�Revision�of�cholera�surveillance�tools� X�
4.11.�Technical�assistance�for�the�study�and�updating�of��surveillance�systems� X� 50,000
4.12.�Updating�of�standards�and�procedures������ �
4.13.�Production�and�dissemination�of�the�aboveͲmentioned�documents� X�
4.14.�Preparation�of�a��legal�framework/RSI�2005�(legal�framework�requiring�private�clinics�to�report�cholera�cases)�
���
4.15.�Updating�of�laboratory�diagnosis�protocols�(technical�assistance)�������
���
200,000
Ensure�better�information�management�for�decisionͲmaking�
4.16.�Training�of�community�health�agents��in�the�use�of�tools�for�community�surveillance��� X�
���������������������
4.17.�Training�of�providers�(doctors,��nurses,�auxiliaries,�and�health�officers)�
X��
�Ensure�better�information�management�for�decisionͲmaking�
![Page 41: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/41.jpg)
41
YEARS�1�AND�2� FINANCING��RESULT�
�ACTIVITIES�
2013/2014� 2014/2015� 2013Ͳ2015�
�EXPLANATORY�NOTES�
4.18.�Training�of�laboratory�technicians�(departmental)� X�
4.19.�Training/rotation�of�departmental�and�centralͲlevel�epidemiologists��� X�
4.20.�Ongoing�training�on�analysis�and�preparation�of�reports� X�
4.21.�Training�for�investigative�teams�and�for�departmental�response� X�
4.22.�Updating�and�dissemination�of�performance�indicators�obtained� X�
4.23.�Updating�of�supervisory�control�tools�and�supervision�of�departmental�and�regional�laboratories�carried�out�regularly.�Operational�situation�room�at�the�central�and�departmental�levels�
X�
4.24.�Regular�dissemination�of�an�epidemiological�bulletin�on�the�cholera�situation���
X�
Ensure�better�information�management�for�decisionͲmaking
SUBTOTAL 1,200,000
![Page 42: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/42.jpg)
INDICATOR:�100%�of�alerts�are�verified�and�investigated,�and�investigative�reports�are�available.�
YEARS�1�AND�2�RESULT� ACTIVITIES�
2013/2015�FINANCING�� EXPLANATORY�NOTES��
5.1.�Organized�local�response�in�targeted�areas�and�in�the�rest�of�the�country�in�accordance�with�standards�� X�
5.2.�Inputs�and�reagents� X�
5.3.�Capacity�for�prepositioning�stock,�rapid�testing,�and�others� X�
200,000Have�reliable�information�for�timely�decisionͲmaking�
5.4.�Repairs/construction�of�new�departmental�laboratory�clinics�involved�in�epidemiological�surveillance�� �
5.5.�Installation�of�space�in�laboratories�to�be�equipped�for�waterͲquality�surveillance�� X� 1,500,000
5.6.�Equipment,�laboratory�accessories�and�reagents,�and��furnishings
�X��
780,000
Have�reliable�information�for�timely�decisionͲmaking�
5.�Epidemiological�surveillance�made�effective�with�a�strengthening�de�of�microbiological�and�environmental�surveillance,�the�establishment�of�a�network�of�laboratories�for�the�decentralization�of�biological�capacity,�and�the�integration�of�investigation,�research,�collection,�and�analysis�of�samples�to�better�and�more�rapidly�understand�the�evolution�of�diseases�
5.7.�Logistical�support�(�transport�system�);��institutional�support�(recruitment�of�qualified�staff)� X� ��320,000
�
�
SPHERE:�EPIDEMIOLOGICAL�SURVEILLANCE���������������������������COMPONENT:�RESEARCH�CAPACITY
42
![Page 43: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/43.jpg)
5.8.�Preparation�of�an�applied�research�program�at�the�hospital�level� �
5.9.�FollowͲup�on�the�resistance�of�Vibrio�cholerae�to�antibiotics� X�
5.10.�Preparation�of�a�national�microbiological,�immunological,�environmental,�and�socioͲanthropological�research�agenda� X�
200,000
5.11ͲProposals�for�appropriate�protocols��Technical�assistance�requested� X�
SUBTOTAL������������������������������������� 3,000,000�
Have�reliable�information�for�timely�decisionͲmaking
GRAND�TOTAL���������������������������������������������������������������������������������������������������������������������������4,200,000�
43
![Page 44: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/44.jpg)
INDICATOR:�By�2015,�70%�of�the�population�washes�their�hands�after�defecating�and�before�eating.��
YEARS�1�AND�2�
FINANCING��RESULTS�
�ACTIVITIES�
2013�Ͳ�2015� 2013�Ͳ�2015�
�EXPLANATORY�NOTES��
6.1.�Intensification�of�interpersonal�communication:��Home�visits�and�community�meetings��
X�480,000
Interpersonal�communication�is�the�best�way�to�reach�families�and�other�organized�groups�in�the�community��
6.2.�Mass�communications�campaign:�ͲProduction�of�audio�and�video�material� X�
6.3.�Dissemination�to�the�media��(including�community�media)� X�
6.4.�Evaluation�of�campaign� X�
1,500,000This�strategy�of�using�the�media�allows�for�covering�several�targets��
�6.�Knowledge�and�skills�related�to�cholera�prevention�measures�promoted�among�the�atͲrisk�population�through�the�integration�of�health�promotion�aptitudes�in�the�primary�health�care�program��
6.5.�Design/production�of�educational�materials:�cartoons,�sketches/mimes,�pamphlets,�brochures�and�posters,�songs,�popular/participatory�theater,�jingles���
X� 600,000
The��production�of�a�range�of�materials�will�facilitate�attaining�the�objectives�because�it�can�reach�specific�groups,�particularly�in�remote�areas��
SPHERE:�HEALTH�PROMOTION����������������������������������������������������COMPONENT:�HYGIENE�PRACTICES�
44
![Page 45: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/45.jpg)
���
6.6.�Acquisition�of�communications�equipment��
X� 1,000,000The�equipment�is�necessary�for�the�production�as�well�as�the�dissemination�of�materials��
YEARS�1�AND�2�
FINANCING�1�AND�2��RESULTS�
�ACTIVITIES�
2014/2015� 2014/2015�
EXPLANATORY�NOTES��
6.7.�Training�of�community�health�agents:�Ͳ�Operationalize�a�network�of�community�health�agents�in�communes�at�risk�for�cholera��
�
X�
�
6.8.�Preparation�of�a�work�guide�for�community�agents� X�
6.9.��Acquisition�of�work�equipment�for�community�health�agents� X�
6.10.�Supervision�and�followͲup�on�the�network�of�agents� X�
5,080,000Strengthening�the�capacity�and�skills�of�community�personnel�can�help�improve�community�management��and�save�lives�
�Strengthened�vigilance�among�the�population�in�the�face�of�the�threat�of�cholera�in�the�country��
6.11.�Training�of�1,200�health�inspectors�Strengthening�the�network�of�health�inspectors� X� 1,490,000
Strengthening�the�capacity�and�skills�of�community�personnel�can�help�improve�community�management��and�save�lives�
45
![Page 46: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/46.jpg)
6.12.�Adaptation�of�training�curriculum�Adapt/design�the�work�guide�for�inspectors��in�terms�of�the�new�Haitian�context�
X�
6.13.�Training�of�senior�technical�staff�of�the�Directorate�for�Health�Promotion�and�Environmental�Protection�(DPSPE)�and�other�government�institutions�involved�
X�
6.14.�Meeting�of�central�and�departmental�coordinators�Ͳ�Intersectoral�collaboration�meetings�
X�
620,000Strengthening�the�capacity�and�skills�of�community�personnel�can�help�improve�community�management��and�save�lives�
6.15.�Sectoral�strengthening:�ͲRecruitment�of�staff�at�the�central,�departmental,�and�communal�levels�
X�
6.16.�Acquisition�of�logistical�support:���Vehicles�� X�
6.17.�Material�and�equipment�for�quality�control�of�drinking�water�from�water�supply�networks�and�water�points���
6.18.�Technical�assistance� X�
820,000
Structural�strengthening�is�a�way�to�guarantee�that�planned�activities�will�be�carried�out�
SUBTOTAL� 11,590,000
46
![Page 47: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/47.jpg)
YEARS�1�AND�2�FINANCING�IN�US$�RESULT� ACTIVITIES�
2013/2015� 2013/2015�
EXPLANATORY�NOTES��
7.1.�Control�of�food�hygiene:�ͲPreparation/dissemination�of�a�communications�plan�for��food�hygiene�and�its�integration�into�the�DPSPE�program�
X�
7.2.�Preparation�of�a�training�guide�for��food�hygiene� X�
7.3.�Preparation�of�awareness�tools�(brochures,�posters,�etc.)� �
7.4.�Integration�of�awareness�activities�about��food�hygiene�into�health�promotion�� �
800,000This�control�has�not�been�assured�for�a�long�period�of�time.�It�is�necessary�to�start�up�the�process�of�considering�different�stages.�
7.5.�Training�of�staff�Training�and�rotation�of�health�inspectors�involved�in�the�control�of�foods���
X�
7.6�.Training�of�street�vendors,�hotel�and�restaurant�staff� X�
240,000
�7.�Food�hygiene�practices�strengthened�in�areas�at�risk�for�cholera�in�order�to�reduce�the��incidence�of�nutritional�and�diarrheal�diseases��
7.7.�Technical�assistance�for�1�year� x� 200,000
Training�of�providers�and�beneficiaries�is�necessary�to�attain�the�objectives�
SPHERE:�HEALTH�PROMOTION������������������������������������� ����������������������COMPONENT:�FOOD�HYGIENE�
47
![Page 48: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/48.jpg)
SUBTOTAL� 1,240,000�
YEARS�1�AND�2�
FINANCING�IN�US$�
RESULT� ACTIVITIES�2013/2015� 2013/2015�
EXPLANATORY�NOTES��
8.1.�Improvement�in�the�nutritional�management�of�cholera�Revision�of�the�cholera�management�protocol�and�introduction�of�zinc�in�addition�to�the�oral�rehydration�solution�
�
X�
�
8.2.�Integration�into�guides�used�in�cholera�awareness�campaigns,�the�introduction�of��zinc�in�addition�to�the�oral�rehydration�solution�
X�
�
8.3.�Training�of�Ministry�staff�at�the�departmental�and�communal�levels�as�well�as�of�NGOs�involved�in�cholera�management�
�
X�
1,100,000The�benefits�from�the�introduction�of�zinc�for�the�management�of�diarrhea�have�been�proven���
8.4.�Supply�of�inputs:�Provision�of�nutritional�ration�to�malnourished�children��with�cholera�
�
X�
�8.�Efforts�to�combat�micronutrient�deficiencies�strengthened�in�areas�vulnerable�to�cholera��
8.5.�Supply�of�zinc�among�the�inputs�that�the�Ministry�provides�to�oral�rehydration�points�and�distributes�to�community�health�agents�
�
X�
6,640,000The�availability�of�inputs�is�indispensable�to�manage�and�attain�the�objectives�
48
![Page 49: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/49.jpg)
8.6.�Structural�Strengthening:�Strengthening�of��nutrition�unit�staff�at�the�central�and�departmental�levels�
X�1,600,000
8.7.�Logistical�support�for�supervision�of�nutrition�activities�in�the�cholera�program�
�
����9,340,000
Structural�strengthening�is�a�way�to�guarantee�that�planned�activities�will�be�carried�out�
� SUBTOTAL� 18,540,000
49
![Page 50: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/50.jpg)
YEARS�1�AND�2�
FINANCING�IN�US$�RESULT� ACTIVITIES�
2013/2015� 2013/2014�
EXPLANATORY�NOTES��
X�9.1.�Implementation�of�hygiene�control�measures�in�hospitals:�Updating�of�standards�and�procedures�for�hospital�hygiene�and�biomedical�waste�
X�
9.2.�Preparation�of�a�plan�for�surveillance�and�prevention�of�nosocomial�infections�
X���
9.3.�Design�of�nosocomial�hygiene�tools� X�
9.4.�Establishment�of�a�plan�for�the�supervision�of�hygiene�behaviors�in�health�institutions� X�
�9.�Protection�of�the�environment�in�health�institutions�is�strengthened�
�
9.5.�Training�session�on�hospital�hygiene�for�the�community�and�departmental�officials�who�are�responsible�for�it�(doctors,�nurses,�sanitary�officers)�
�
200,000The�current�situation�in�terms�of�hygiene�at�health�institutions�constitutes�a�risk�for�beneficiaries,�relatives,�and�visitors.�A�global�hospital�hygiene�plan�is�important�to�avoid�nosocomial�infections.�
SPHERE:�HEALTH�PROMOTION �������������������������������������������������COMPONENT:� HOSPITAL�HYGIENE�
50
![Page 51: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/51.jpg)
9.6.�Construction�of�15�wastewater�treatment�stations�Rotation�of�the�training�of�technical�staff�involved�at�hospitals�
X�
9.7.�Acquisition�of�logistical�support�(2�vehicles,�scooters,�motorized�pumps�and�accessories,�chemical�products,�and�protection�materials)�
X�
9.8.�Reevaluation�of�water�storage�structures�at�the�institutional�level�� X�
9.9.�Expansion�of�the�SISKLOR�system:�Training�of�staff�in�charge�of�disinfecting�water�and�controlling�chlorine�residue�Acquisition�of�control�kits,�disinfectant�
X�
230,000
Implementing�the�SISKLOR�system�for�quality�control�of�water�at�health�facilities�is�in�progress.�It�would�be�useful�to�expand�it�to�all�health�institutions.��
9.10.�Improvement�in�the�skills�of�providers�and�in�the�infrastructure�for�the�management�of�medical�waste�
X�
9.11.�Training�and�rotation�of�health�providers�and�support�staff�
9.12.�Acquisition�and�installation�of�equipment�for�the�treatment�of�hospital�waste�(50�incinerators).�Supplies�(garbage�cans,�bags,�scrubs,�boots,�tillage�tools,�etc.)�and�consumables��
X�
1,420,000
The�program�for�the�management�of�hospital�waste�has�been�implemented.�The�rotation�of�staff�and�the�lack�of�incinerators�explain�the�need�for�training�of�senior�staff�and�the�acquisition�of�incinerators�and�protection�gear.�
51
![Page 52: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/52.jpg)
9.13.�Improvement�in�the�handling�of�cadavers:�Review�and�publication�of�standards�and�procedures�for�the�handling�of�cadavers�of�patients�with�cholera�
X�
9.14.�Training�of�staff�in�funeral�homes�and�hospital�morgues�in�the�handling�of�cadavers�of�those�who�were�sick�with�cholera�� X�
�
9.15.�Support�for�periodic�surveillance�of�funeral�homes�and�morgues�in�health�facilities�
X�
44,000
The�handling�of�cadavers�is�one�of�the�elements�that�must�be�taken�into�account��to�disrupt�the�cholera�transmission�chain,�because�poor�handling�of�the�bodies�of�cholera�patients�often�constitutes�a�mode�of��transmission�for�the�disease�
� SUBTOTAL� 2,154,000�
�GRAND�TOTAL� 24,074,000
�
52
![Page 53: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/53.jpg)
53
INDICATORS�FOR�ACTIVITIES�ACTIVITIES�
ACCORDING�TO�THE�ACTION�PLAN� FINANCING�2013Ͳ2015�
SUBTOTAL:��Management�and�vaccination� 35,030,000 26,649,100�
SUBTOTAL:�Inputs� 63,660,000 54,824,000�
SUBTOTAL:��Epidemiological�surveillance�� 4,200,000 4,200,000�
SUBTOTAL:��Health�promotion�� 16,984,000 24,074,000�
GRAND�TOTAL� 119,874,000 109,747,100�
![Page 54: MINISTRY OF PUBLIC HEALTH AND PO PULATION ......The National Plan for the Elimination of Cholera calls for the leration over the first two years of systematic emergency measures at](https://reader034.fdocuments.us/reader034/viewer/2022042419/5f365cebfe47b3492454efe8/html5/thumbnails/54.jpg)